| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - | SPG AND STL PO BOX 95287 CHICAGO, IL 60694 | DELTA DENTAL OF MISSOURI | $21K | $905 | $22K | 10.30% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC - CH | PO BOX 736061 CHICAGO, IL 60673 | DELTA DENTAL OF MISSOURI | — | $671 | $671 | 0.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1411 OPUS PL STE 400 DOWNERS GROVE, IL 60515 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 5.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 5.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1411 OPUS PL STE 400 DOWNERS GROVE, IL 60515 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 12.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - | SPG AND STL PO BOX 95287 CHICAGO, IL 60694 | ADVANTICA INSURANCE COMPANY | $3K | $132 | $3K | 10.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | OF ST LOUIS MO 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 11.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $162 | $162 | 0.73% |
| BLOCK, CHARLES, D3 | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $117 | $4 | $121 | 0.54% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $117 | $4 | $121 | 0.54% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 16666 OLD CHESTERFIELD RD CHESTERFIELD, MO 63017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $100 | — | $100 | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | OF ST LOUIS MO 21ST FL TWO PIERCE PLACE ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 27.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $660 | $660 | 3.63% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 16666 OLD CHESTERFIELD RD CHESTERFIELD, MO 63017 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $208 | — | $208 | 1.14% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS CHRISTOPHER | PO BOX 40386 798 BERRY ROAD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $202 | — | $202 | 1.11% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.28% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.16% |
| LOVELACE, JOHN, E3 | 2613 HAMPTON RD ST CHARLES, MO 63303 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1411 OPUS PL STE 400 DOWNERS GROVE, IL 60515 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $599 | $599 | 5.94% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 352 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 617 | $216K |
| Vision | ADVANTICA INSURANCE COMPANY | 475 | $32K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $84K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 74 | $22K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $88K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.